[Tension pneumocephalus after surgical treatment of a bilateral chronic subdural hematoma: a banal and serious complication]. / Pneumocéphalie compressive après traitement chirurgical d'un hématome sous-dural chronique bilatéral: une complication banale et sérieuse.

The occurrence of postoperative pneumocephalus is a common event and is often trivial. When the intracranial air volume is significant, it creates intracranial hypertension causing tension pneumocephalus. This case report describes the occurrence of tension pneumocephalus after surgical drainage of bilateral chronic subdural hematoma. The pneumocephalus was responsible for severe postoperative neurological deterioration. The attending physicians should be aware of the possibility of occurrence of such complication. Treatment and prevention of pneumocephalus should also be well known by the medical staff.

[Neuroepithelial thalamo-mesencephalic cyst]. / Kyste neuroépithélial thalamo-mésencéphalique.

Thalamo-mesencephalic neuroepithelial cysts are rare lesions of the central nervous system. They are thought to arise from neuroectoderm and are also referred to as ependymal cysts due to their origin. It can remain asymptomatic throughout life or rarely can cause symptoms. We describe a 42-year-old woman who presented with thalamic syndrome due to a neuroepithelial cyst of the thalamo-midbrain. Differential diagnosis is made with other cystic lesions in the brain. However a good analysis of imaging feature led to diagnosis. When the lesion is symptomatic, mini-invasive procedure is indicated.

Acute spontaneous subdural hematoma: an unusual form of cerebrovacular accident.

An acute subdural hematoma is commonly regarded as a complication of a head injury, and bleeding is associated with contusion or laceration of the bridging vein in the subdural space. Occasionally, reports describe non traumatic acute subdural bleeding from the rupture of cerebral aneurysm or vascular malformation. However, acute spontaneous subdural hematomas (ASDH) of arterial origin, without any traumatic history or vascular anomaly, are rarely reported in literature. Here we describe two cases who presented with acute signs of intracranial hypertension secondary to a spontaneous acute subdural hematoma in which spontaneous bleeding from a small cortical artery was seen during operation.

[Cerebellar mutism after removal of a vermian medulloblastoma in an adult]. / Mutisme cérébelleux après ablation d'un médulloblastome vermien chez un adulte.

Cerebellar mutism is a rare postoperative phenomenon that generally occurs in children after resection of a cerebellar mass lesion. A 22-year-old man developed cerebellar mutism after posterior fossa surgery for a mass lesion in the vermis. Histological examination showed a medulloblastoma. The tumor was totally removed via a suboccipital approach. The patient developed mutism on the first postoperative day, which persisted for two weeks. Thereafter, this condition gradually improved. Although pathophysiology and the anatomical substrate of cerebellar mutism still remain unclear, it is important that neurosurgeons be aware of this syndrome after posterior fossa surgery in adults. This phenomenon usually has a self-limiting course and a favorable prognosis for resolution within the first three months.

[Intradiploic epidermoid cyst of the occipital bone]. / Kyste épidermoïde intradiploïque de l'os occipital.

BACKGROUND: A rare case of intradiploic epidermoid cyst of the occipital bone is described and recent literature, which emphasizes the radiological evaluation and surgical treatment of this lesion is reviewed. CASE DESCRIPTION: A 56-year-old female patient complained of headache and occasional episodes of vertigo for one year. Computed tomographic scan and magnetic resonance imaging were performed. The patient underwent occipital right craniotomy followed by total removal of the cyst and its capsule. RESULT: The postoperative course was uneventful and the patient was discharged 4 days later. CONCLUSION: A review of the literature shows that intradiploic epidermoid cyst of the occipital bone is rare. Correct radiological assessment and complete excision of this lesion and its capsule provides complete recovery.

[Spheno-orbital mesenchymal chondrosarcoma. A case report]. / Chondrosarcome mésenchymateux sphéno-orbitaire. A propos d'un cas.

Mesenchymal chondrosarcoma is a highly malignant and extremely rare tumor of the orbit: only 18 cases have been reported to date. We report a case of spheno-orbital mesenchymal chondrosarcoma in a 36-year-old woman presented with a 4-month history of progressive left exophthalmia and temporal mass. A CT-scan of the orbit and MRI showed a spheno-orbital mass, with temporal fossa extension, fed by the internal maxillary artery visible on cerebral angiography. Surgery via a transcranial, left frontotemporozygomatic approach after selective embolization enabled subtotal removal. Definitive histologic examination revealed mesenchymal chondrosarcoma. Postoperatively, exophthalmia spectacularly regressed. We report our clinical findings and present a review of the literature.